Yokota Shu, Ottervanger Jan Paul, Mouden Mohamed, Timmer Jorik R, Knollema Siert, Jager Pieter L
Department of Cardiology, Isala Klinieken, Dokter Van Heesweg 2, 8025 AB, Zwolle, The Netherlands.
J Nucl Cardiol. 2014 Apr;21(2):284-90. doi: 10.1007/s12350-013-9837-5. Epub 2014 Jan 28.
False-negative myocardial perfusion imaging (MPI) can by due to left main (LM) or three-vessel disease causing "balanced ischemia". However, so far prevalence of LM or three-vessel-disease in patients with normal MPI is unclear. We assessed prevalence, location, and extent of significant coronary artery disease (CAD) in patients with normal MPI.
Between 2006 and 2010, 256 patients with normal MPI who had invasive angiography because of persisting or worsening of the same initial symptoms were studied. Significant CAD was defined as stenosis > 70% or LM > 50%.
A total of 93 patients (36%) had significant CAD. Significant CAD was observed more frequently in males, higher age and those with typical angina complaints. Significant LM disease was present in 7%, three-vessel disease in 10%, two-vessel disease in 22%, and single vessel disease (not left main) in 61%. In those with single vessel disease, the location was the LAD in 40%, the RCA in 30%, and the LCX in 30%.
In selected patients with normal MPI, one-third had significant CAD. The majority of these patients had single vessel disease (not left main). LM or three vessel disease, causing "balanced ischemia", is a less common cause of false-negative MPI.
心肌灌注成像（MPI）假阴性可能是由于左主干（LM）或三支血管病变导致“均衡性缺血”。然而，目前MPI正常的患者中LM或三支血管病变的患病率尚不清楚。我们评估了MPI正常患者中显著冠状动脉疾病（CAD）的患病率、位置和范围。
2006年至2010年间，对256例MPI正常但因初始症状持续或加重而接受有创血管造影的患者进行了研究。显著CAD定义为狭窄>70%或LM>50%。
共有93例患者（36%）患有显著CAD。显著CAD在男性、年龄较大以及有典型心绞痛症状的患者中更常见。显著LM病变占7%，三支血管病变占10%，两支血管病变占22%，单支血管病变（非左主干）占61%。在单支血管病变患者中，病变位于左前降支（LAD）的占40%，位于右冠状动脉（RCA）的占30%，位于左旋支（LCX）的占30%。
在选定的MPI正常患者中，三分之一患有显著CAD。这些患者大多数为单支血管病变（非左主干）。导致“均衡性缺血”的LM或三支血管病变是MPI假阴性的较不常见原因。
